How much rates vary
Facilitymedian $1,380 · 10th to 90th $575 to $3,467Professionalmedian $1,622 · 10th to 90th $1,148 to $3,715
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,288.25 Median $1,318.26 Typical High $8,317.64 | Facility | None | $1,288.25 | $1,318.26 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,513.56 | Professional | None | $1,318.26 | $1,318.26 | $1,513.56 |
BCBS North Carolina Setting Facility Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,819.70 | Facility | None | $912.01 | $1,348.96 | $1,819.70 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $3,715.35 | Professional | None | $1,412.54 | $1,778.28 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,995.26 Typical High $2,454.71 | Facility | None | $645.65 | $1,995.26 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $3,090.30 | Professional | None | $1,023.29 | $1,202.26 | $3,090.30 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $3,090.30 | Professional | None | $1,548.82 | $1,548.82 | $3,090.30 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $794.33 Typical High $2,884.03 | Facility | None | $602.56 | $794.33 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,258.93 | $1,584.89 | $2,238.72 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $3,467.37 | Professional | None | $1,047.13 | $1,348.96 | $3,467.37 |
14 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $660.69 Typical High $758.58 | Professional | 52 · Reduced service | $660.69 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $302.00 | Professional | 53 · Discontinued | $263.03 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $223.87 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $151.36 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,047.13 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,202.26 Typical High $4,365.16 | Facility | 50 · Both sides | $891.25 | $1,202.26 | $4,365.16 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $398.11 Typical High $1,445.44 | Facility | 51 · Multiple procedures | $295.12 | $398.11 | $1,445.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,344.23 Typical High $5,011.87 | Professional | 50 · Both sides | $1,862.09 | $2,344.23 | $5,011.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $630.96 Median $794.33 Typical High $1,698.24 | Professional | 51 · Multiple procedures | $630.96 | $794.33 | $1,698.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $316.23 Typical High $676.08 | Professional | 80 · Assistant surgeon | $251.19 | $316.23 | $676.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $177.83 Median $218.78 Typical High $467.74 | Professional | 81 · Minimal assistant surgeon | $177.83 | $218.78 | $467.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $218.78 Typical High $467.74 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $218.78 | $467.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $218.78 Typical High $467.74 | Professional | AS · PA/NP assist | $177.83 | $218.78 | $467.74 |
Where North Carolina sits
The same service costs 3.7 times more in Alaska than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
AK $8,917DE $2,410
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.